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General NPI Number Information
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NPI Number | 1396515474
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Entity Type | Organization
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Legal Business Name | LEGACY COUNSELING
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Dates
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Enumeration Date | 01/08/2024
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Last Update Date | 01/08/2024
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Provider Practice Location Address
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Address Line | 70 N MAIN ST
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City | CANANDAIGUA
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State | NY
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Zip | 14424-1468
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Country | US
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Telephone | 585-201-8463
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Fax |
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Provider Business Mailing Address
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Address Line | 70 N MAIN ST
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City | CANANDAIGUA
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State | NY
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Zip | 14424-1468
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Country | US
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Telephone | 585-201-8463
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Fax |
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Authorized Official
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Title or Position | MANAGER/LMFT/CEO
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Name | DENISE LEONARD
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Credential | LMFT
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Telephone | 585-201-8463
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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